Today, the Massachusetts Department of Public Health (DPH) released a groundbreaking report confirming what labor advocates have been saying for years: dangerous jobs are playing a direct role in opiate addiction and overdoses in the state.

The 21-page study titled Opioid-related Overdose Deaths in Massachusetts by Industry and Occupation, 2011-2015 found that there were a total of 5,580 opioid-related overdose deaths in Massachusetts from 2011 through 2015. Of the 4,284 worker death certificates deemed comprehensive enough to study, 1,096 were found to be employed in construction/extraction. The opioid-related death rate for these workers was six times the average rate for all Massachusetts workers with 150.6 deaths per 100,000 workers as compared to the 25.1 average. Workers in the farming, fishing and forestry occupation were also very hard hit. With 61 deaths in that industry during the study period (67.2% of these deaths occurred among workers employed in fishing occupations), the rate was five times higher than average. Click here to view the report.

The occupations within construction and extraction that suffered heavy losses include:

Painters, construction and maintenance, with 92 deaths, 8.4% of all construction worker deaths;

Pipe layers, plumbers, pipefitters, and steamfitters, with 66 deaths, 6.0% of all construction worker deaths; and

Roofers with 64 deaths, 5.9% of all construction worker deaths.

The study calls for educational and policy interventions targeting at-risk workers as a means to prevent opioid-related overdose deaths. DPH states these interventions should immediately address workplace hazards that cause injuries for which opioids are prescribed to save lives.

The Massachusetts Coalition for Occupational Safety and Health (MassCOSH) was provided an advance copy of the document as a stakeholder working to better understand the role work plays in the region’s opioid epidemic.

“This sobering report confirms that hazardous jobs are not just dangerous because of the risk of fatal injury, but because they can also directly lead to tragic opioid addiction that can shatter families and end lives,” said MassCOSH Executive Director Jodi Sugerman-Brozan. “It also makes clear that if those working to end the opioid epidemic in our state are not looking at investing in policies and efforts that reduce work-related injuries, they are missing a key strategy.”

Low wage earners were particularly hard hit by opioid-related overdose death. High rates of overdose death were observed among workers in the $10,000- $19,999, and $20,000- $29,999 income range. Death rates were also examined in relation job insecurity and availability of paid sick leave. A significantly higher death rate was observed among workers in occupation groups with high job insecurity compared with workers in occupation groups with low job insecurity.

The report also goes into great detail linking jobs with a high prevalence of musculoskeletal pain, such as lower back pain, with the need to work while in pain, contributing to the use and potential overdoes of opioids. The study cites a recent Massachusetts study by the Journal of occupational and environmental medicine/American College of Occupational and Environmental Medicine of construction workers on a large commercial construction site. 74% of the workers reported having some kind of musculoskeletal pain in the last three months and about 40% reported having one or more injuries in the last month. Advocates state these workers are unable to take time off to heal and work though their pain, exacerbating their injuries and increasing their medication intake, leading to addiction.

“This is a very important report,” said Les Boden, professor at the Boston University School of Public Health and member of the MassCOSH Health Tech Committee. “It shows that industries and occupations with high injury rates also have high rates of opioid-related deaths. This strongly suggests that workers suffering from injury-related pain have often been prescribed opioids to control their pain. This can begin a chain of events leading to addiction and death. The best way to address these problems is to prevent these injuries in the first place.”

DPH states that although the opioid epidemic is multifaceted and additional research is necessary, given the strong evidence that dangerous jobs are linked to opioid-related death, they recommend immediate action be taken to prevent workplace injuries.

“With thousands of workers being exposed to opioids and dying, this report is a resounding call to action to better protect our labor force,” said Sugerman-Brozan. “We call on our leaders to fully staff and fund the Occupational Safety and Health Administration and the Massachusetts Occupational Health Surveillance Program, reinstate the Workplace Injury and Illness recordkeeping rule that required employers to keep five years of workplace injury records, legislate increased access to paid sick leave, and empower unions, not hamper them, in their efforts to improve working conditions for their members. These are steps we can take right now to help end all this needless suffering and loss.”